Auricular acupuncture for chemically dependent pregnant women: a randomized controlled trial of the NADA protocol

Abstract

Background: The prevalence of maternal drug use during pregnancy in North America has been estimated to be as high as 6-10%. The consequences for the newborn include increased risk for perinatal mortality and ongoing physical, neurobehavioral, and psychosocial problems. Methadone is frequently used to wean women off street drugs but is implicated as a cause of adverse fetal/neonatal outcomes itself. The purpose of our study was to test the ability of maternal acupuncture treatment among mothers who use illicit drugs to reduce the frequency and severity of withdrawal symptoms among their newborns. Methods: We randomly assigned chemically dependent pregnant women at BC Women's Hospital in Vancouver, British Columbia to daily acupuncture treatments versus usual care. By necessity, neither our participants nor acupuncturists were blinded as to treatment allocation. Our primary outcome was days of neonatal morphine treatment for symptoms of neonatal withdrawal. Secondary neonatal outcomes included admission to a neonatal ICU and transfer to foster care. Results: We randomized 50 women to acupuncture and 39 to standard care. When analyzed by randomized groups, we did not find benefit of acupuncture; the average length of treatment with morphine for newborns in the acupuncture group was 2.7 (6.3) compared to 2.8 (7.0) in the control group. Among newborns of women who were compliant with the acupuncture regime, we observed a reduction of 2.1 and 1.5 days in length of treatment for neonatal abstinence syndrome compared to the non-compliant and control groups, respectively. These differences were not statistically significant. Conclusions: Acupuncture may be a safe and feasible treatment to assist mothers to reduce their dosage of methadone. Our results should encourage ongoing studies to test the ability of acupuncture to mitigate the severity of neonatal abstinence syndrome among their newborns. Clinical Trial Registration: http://www.clinicaltrials.gov registry: W05-0041

Laser Acupuncture for Neonatal Abstinence Syndrome: A Randomized Controlled Trial

“…Janssen et al 42 randomly assigned pregnant women to either acupuncture or standard care and (14) 4 (29) .648 1-min Apgar score 9 (9-9) 9 (9-9) .756 5-min Apgar score 10 (10-10) 10 (10-10) .756 Microcephaly 1 (7) 3 (21) .596 Maternal nicotine misuse 14 (100) 10 (71) .098…”

The History, Mechanism, and Clinical Application of Auricular Therapy in Traditional Chinese Medicine

“…Janssen et al (2012) evaluated the effect of AA (NADA protocol) in pregnant women with drug dependence and found that AA did not have benefit more than the control group. However, the use of methadone may induce an adverse event in the fetus, and AA may be a safe method [ 85 ].…”

Acupuncture Treatment of Substance Use Disorders

“…Recently, more studies have produced negative results, suggesting that auricular acupuncture might have no effect on withdrawal severity, craving and attendance when provided as an adjunct to methadone treatment services [25][26][27]. Overall, the use of the NADA protocol as a treatment for addiction does not seem to support clinical trials with large sample sizes.…”